T-cell-rich B-cell lymphoma

Am J Surg Pathol. 1988 Jun;12(6):433-43. doi: 10.1097/00000478-198806000-00003.

Abstract

Five cases of B-cell lymphoma are described in which the morphology and initial immunohistochemistry suggested a diagnosis of T-cell neoplasia. In four cases, the histological picture was that of an adult pleomorphic T-cell lymphoma; the fifth case was a lymphocytic lymphoma (CLL) with an accompanying T-cell lymphocytosis in the peripheral blood. Immunohistochemistry on both frozen and paraffin-embedded material showed that the cellular population in all five cases consisted mainly of T-cells; less than 10% of the cells stained as B-cells. However, immunoglobulin immunostaining combined with use of the new lineage-related monoclonal antibodies reactive in paraffin section revealed that the B-cells constituted the neoplastic population. Genetic analysis showed no evidence of clonality in the T-cells, nor was it able to detect rearrangement in the small number of clonal B-cells present. These cases represent a variety of B-cell neoplasia that mimicks T-cell lymphoma morphologically and immunologically. The vigorous T-cell reaction seen in such lymphomas means that the malignant population can be correctly identified only by careful examination of the immunohistochemical findings.

MeSH terms

  • Antibodies, Monoclonal
  • B-Lymphocytes / pathology*
  • Biopsy
  • Diagnosis, Differential
  • Frozen Sections
  • Humans
  • Immunoenzyme Techniques
  • Lymph Nodes / pathology*
  • Lymphoma / metabolism
  • Lymphoma / pathology*
  • T-Lymphocytes / pathology*

Substances

  • Antibodies, Monoclonal